Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Appropriateness”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMedDate not supplied

Advances in meta-analysis as a research method.

Meta-analysis is a method of data analysis applied to summarizing research findings, both quantitative and qualitative summaries of individual studies. Rooted in the fundamental values of the scientific enterprise of replicability, causal and correlational analysis, it is useful for answering three general questions: What is the central tendency or typical study outcome? How much variability exists among study outcomes? What is the explanation of the variability? Advanced statistical and mathematical techniques are being used in counting studies with significant and non-significant findings; in combining effect size estimates based on fixed- or random-effects models; in the use of general linear models; and, Bayesian procedures. The methodology of meta-analysis and suggestions for publications are presented as well as appropriate software programs available for use in the meta-analytic process are explored. The benefits of meta-analysis as a research method in effecting health policy development is offered as a pragmatic perspective for future consideration. Conclusions have implications for the use of meta-analysis as a teaching strategy and as a methodology in nursing research and other applied sciences. In view of the rapid pace of knowledge development and increased public demand for accountability, meta-analysis offers an opportunity for organizing phenomena which gives direction for provision of quality health care.

Humans↗
PubMed1998

The prevalence of risk factors among women in the United States by race and age, 1992-1994: opportunities for primary and secondary prevention.

OBJECTIVE: To analyze the prevalence of 11 modifiable behavioral risk factors, including multiple risk factors, among white, black, Asian and Pacific Islander, American Indian, and Hispanic women in the United States. DESIGN: We used Behavioral Risk Factor Surveillance System (BRFSS) data for 1992 to 1994 to examine risk factors (smoking; obesity; diabetes; heavy alcohol consumption; sedentary lifestyle; and inadequate use of seat belts, pap smears, consumption of fruits or vegetables, mammography and colorectal screening, and immunization), among women age 18 to 49, 50 to 64, and 65 and older. We also conducted a multiple regression analysis, comparing the odds of having either 1-2 versus 0 or 3 or more versus 0 risk factors among racial/ethnic groups, controlling for education and family income, to see if racial/ethnic differences can be attributed to socioeconomic differences. RESULTS: US women engage in a variety of behaviors that place them at risk for many causes of morbidity and mortality. Risk profiles vary substantially among racial/ethnic populations: Pacific Islanders have relatively low prevalences of most major risk factors, while blacks and American Indians have relatively high prevalences of many major risk factors. Prevalence differences among racial/ethnic populations are diminished but not eliminated when socioeconomic factors are accounted for. CONCLUSIONS: Appropriately designed programs to help women reduce their behavioral risk factors are needed. Action by health care providers, communities, and policy makers can substantially improve the health of women in the United States.

Adolescent↗
PubMed1998

Complications after treatment of proximal femoral fractures.

BACKGROUND AND AIMS: The number of fractures of the proximal femur is increasing faster than the number of elderly people. The aim of the study was to record all complications after operative treatment of proximal femoral fractures in order to reduce the incidence of these complications in the future. MATERIAL AND METHODS: The files of 334 patients with proximal femoral fractures were retrospectively analyzed. The number of all general and operative complications were recorded. RESULTS AND CONCLUSIONS: The primary mortality was 8 percent. The most common general complication was a thromboembolic one. Local complications were recorded in 66 cases. Thirty-eight percent of femoral neck fractures treated by internal fixation were complicated. Increased attention should be focused on the sufficient antithrombosis prophylaxis, which should be continued at least during the whole convalescence period at the hospital. It remains to be clarified, if improved technical skill may improve the results of femoral neck osteosynthesis, which in this group of patients appeared far from satisfactory. The development of post-operative care and selection of right patients to an appropriate rehabilitation program is perhaps the most important factor today, in order to reduce complications in general.

Adult↗
PubMed1998

[Analysis of preventive behavior for accidents among adolescents in our setting].

OBJECTIVE: Our objective was to analyze the preventative behavior for accidents in adolescents in our environment. PATIENTS AND METHODS: The accident preventative behavior of adolescents was studied by means of an anonymous questionnaire distributed to 268 students in a secondary school. A descriptive study regarding hazardous agents was conducted. We studied the relationships between the age, sex, number of siblings and the educational and economic level of the parents. RESULTS: Our study identifies deficiencies in the prevention of burns, traffic accidents and alcohol consumption. We detected the influence of age, sex, number of siblings and sociocultural level of the parents. CONCLUSIONS: The prevalence of a high risk attitude in adolescents suggests that appropriate counseling by pediatricians and appropriate prevention programs should be implemented.

Accident Prevention↗
PubMed1998

1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Diabetes Association.

OBJECTIVE: To revise and expand the 1992 edition of the clinical practice guidelines for the management of diabetes in Canada incorporating recent advances in diagnosis and outpatient management of diabetes mellitus and to identify and assess the evidence supporting these recommendations. OPTIONS: All aspects of ambulatory diabetes care, including organization, responsibilities, classification, diagnosis, management of metabolic disorders, and methods for screening, prevention and treatment of complications in all forms of diabetes were reviewed, revised as required and expressed as a set of recommendations. OUTCOMES: Reclassification of types of diabetes based on pathogenesis; increased sensitivity of diagnostic criteria; recommendations for screening for diabetes; improved delivery of care; recommendations for tighter metabolic control; and optimal methods for screening, prevention and treatment of complications of diabetes. EVIDENCE: All recommendations were developed using a justifiable and reproducible process involving an explicit method for the citation and evaluation of the supporting evidence. VALUES: All recommendations were reviewed by an expert committee that included people with diabetes, family physicians, dietitians, nurses, diabetologists, as well as other subspecialists and methodologists from across Canada. BENEFITS, HARM AND COSTS: More aggressive screening strategies and more sensitive testing and diagnostic procedures will allow earlier detection and management of diabetes. Cost-effectiveness analyses suggest that this will lead to savings in health care costs relating to diabetes care by reducing the incidence of complications of diabetes. Similarly, tighter metabolic control in most people with diabetes, through intensive diabetes management, seeks to reduce the incidence of complications and, hence, their associated social and economic burdens. RECOMMENDATIONS: This document contains numerous detailed recommendations pertaining to all aspects of ambulatory diabetes care, ranging from service delivery to prevention and treatment of diabetes-related complications. The terms "insulin-dependent diabetes mellitus" and "non-insulin-dependent diabetes mellitus" should be replaced by the terms "type 1" and "type 2" diabetes. Testing for diabetes using fasting plasma glucose (FPG) level should be performed every 3 years in those over 45 years of age. More frequent or earlier testing should be considered for people with additional specific risk factors for diabetes. The FPG level at which diabetes is diagnosed should be reduced from 7.8 to 7.0 mmol/L to improve the sensitivity of the main diagnostic criterion and reduce the number of missed diagnoses. Depending on the type of diabetes and the therapy required to achieve euglycemia, people with diabetes should generally strive for close metabolic control to achieve optimal glucose levels. This entails receiving appropriate diabetes education through a diabetes health care team, diligent self-monitoring of blood glucose, attention to lifestyle and adjustments in diet and physical activity, and the appropriate and stepwise use of oral agents and insulin therapies needed to maintain glycemic control. Also highlighted is the need for appropriate surveillance programs for complications and management options. VALIDATION: All recommendations were graded according to the strength of the evidence and consensus of all relevant stakeholders. Collateral efforts of the American Diabetes Association and the World Health Organization and the input of international experts were also considered throughout the revision process.

Canada↗
PubMed1998

[The interpreter in an intercultural clinical milieu].

The public's diversified language profile means that nursing practice must adjust to provide the same quality of care to all clients, no matter what language they speak. To improve quality and quantity of information exchanged in the nurse-client-interpreter triangle, the authors have investigated the type of information likely to be filtered and studied the various factors underlying the interpreter's choice to filter information. The authors also analyzed the values interpreters assign to information and the factors that form the background for filtering, including mistrust. The authors suggest adequately preparing interpreters; using interpreters' expertise; and developing an appropriate training program for intercultural interpreters to enable them to better function within health care institutions.

Communication↗
PubMed2006

Violence against American Indian Women and the Services-Training-Officers-Prosecutors Violence Against Indian Women (STOP VAIW) program.

When Congress appropriated funds to develop ways to reduce violence against American Indian women, tribal elders faced a challenging task: find ways to cooperate with various tribal and nontribal criminal justice agencies and navigate the maze of law enforcement authority. An evaluative study was conducted of these programs and the different approaches used to help keep women safe by American Indian tribal governments. This study found that the tribes rose to the challenge; the money was making a difference. The grants to stop violence against Indian women have made a significant impact in the 134 native communities that received awards.

Arizona↗
PubMed2005

[Activities programs for institutionalized elderly patients with dementia].

Formal caregivers often play an important role in leading activities programs and arranging appropriate therapeutic activities in institutions. Studies have shown that, when elderly patients with dementia have participated in more structured activities, agitated behaviors have been significantly decreased. Also, structured activities have helped in the performance of ADL, as well as improved quality of sleep, decreased anxiety, improved self-expression and social interaction, enhanced caregiver's morale, and resulted in a more positive caring attitude on the part of caregivers. This article will discuss the categories and contents of activities programs for elderly patients with dementia and can be applied as a reference to assist formal caregivers in their efforts to arrange appropriate activities programs in institutions.

Aged↗
PubMed1991

Infections transmitted by large and small laboratory animals.

Although zoonotic spread of infectious disease continues to occur in laboratory animals used in biomedical research, reported outbreaks have been minimized with the advent of rigorous veterinary and husbandry procedures, the use of commercially reared animals, and the institution of appropriate personnel health programs. Maintaining animals in modern facilities with appropriate safeguards against introduction of vermin and biologic vectors is also important in preventing zoonotic disease in personnel. Nevertheless, established zoonotic agents, newly discovered microorganisms, or new animal species not previously recognized as carriers of zoonotic microorganisms are encountered, and the potential for spread of infectious disease from animals to humans still exists. Active dialogue between veterinarians and physicians regarding the potential of zoonotic disease, the species of animals that are involved, and the methods of diagnosis, is an indispensable component of a successful preventive health program involving personnel who deal with laboratory animals.

Animals↗
PubMed2001

False-negative results in screening programs. Medical, psychological, and other implications.

OBJECTIVES: Assessment of the appropriateness of screening programs involves consideration of the harms as well as the benefits. These harms include the risk of false-negative results, the consequences of which have remained underinvestigated. This paper reports the results of a systematic literature review that aimed to assess the medical psychological, economic, and legal consequences of false-negative results in national screening programs. METHODS: The review included a comprehensive literature search and contact with experts to identify relevant literature. Most studies that were identified presented only anecdotal evidence. However, thirteen studies presented quantitative information on medical consequences of false negatives, eight studies presented information on psychological consequences, and two studies presented information on economic consequences. RESULTS: The strength of evidence from most of the primary studies was low. There is some evidence, however, that false-negative results may have a large legal impact. There is also a consensus in the literature that false negatives may have a negative impact on public confidence on screening; evidence is however limited. CONCLUSIONS: False negatives are evident even in high-quality screening programs. They may have the potential to delay the detection of breast and cervical cancer, but there is little evidence to help in assessing their psychological consequences. They also may lead to legal action being taken by those affected and may reduce public confidence in screening. Their impact may be reduced by provision of full information to participants about the benefits and limitations of screening programs and by increasing public education on these issues.

False Negative Reactions↗
PubMed1998

Management of COPD. Early identification and active intervention are crucial.

Medical management of COPD begins with an awareness of risk factors and identification of at-risk patients. Once disease is identified, patient and family education, a smoking cessation program, and an appropriate bronchodilator regimen should be initiated. Airway secretions and infections should be minimized, hypoxemia corrected, and other secondary physiologic disturbances evaluated when appropriate. Participation in a comprehensive pulmonary rehabilitation program can markedly improve symptoms, function, exercise performance, and quality of life. The results are a reduction in patient limitations, medical expenses, and dependence on medical facilities and caregivers.

Anti-Inflammatory Agents↗
PubMed2005

Culturally appropriate HIV/AIDS and substance abuse prevention programs for urban Native youth.

This article will examine HIV/AIDS and substance abuse prevention for urban Native youth in Oakland, California. It will highlight the Native American Health Center's Youth Services programs. These programs incorporate solutions based on a traditional value system rooted in Native culture and consisting of youth empowerment, leadership training, prevention activities, traditional cultural activities and wellness and life skills education. They aim to reduce HIV/AIDS and substance abuse risk for American Indian/Alaska Native (AI/AN) youth through structured, community-based interventions. The Youth Services Program's events, such as the Seventh Native American Generation and the Gathering of Native Americans, offer effective and culturally relevant ways of teaching youth about American Indian/Alaska Native history, intergenerational trauma, and traditional Native culture. Satisfaction surveys gathered from these youth provide invaluable data on the positive effects of these prevention efforts. The need for culturally relevant and culturally appropriate HIV/AIDS and substance abuse prevention programs for urban AI/AN youth is apparent. These prevention efforts must be creatively integrated into the multidimensional and complex social structures of Native American youth.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Evaluating audio-visual and computer programs for classroom use.

Appropriate faculty decisions regarding adoption of audiovisual and computer programs are critical to the classroom use of these learning materials. The author describes the decision-making process in one college of nursing and the adaptation of an evaluation tool for use by faculty in reviewing audiovisual and computer programs.

Audiovisual Aids↗
PubMed2004

What is the appropriate health policy content in a program curriculum?

Faculties of graduate health administration programs have considerable flexibility in applying curriculum guidelines established by the Accrediting Commission on Education for Health Services Administration (ACEHSA) to help achieve their self-determined missions. When a program's mission includes preparing graduates for eventual careers at the strategic levels of healthcare organizations, specific health policy content is appropriate. In determining this curriculum content, faculties can be guided by the need to prepare graduates to accomplish three policy-related activities that are vital to successful strategic management: 1. comprehend and understand relevant governmental health policy aspects of a healthcare organization's external environment, including assessing the impact of these aspects of the environment on the organization; 2. lead strategic responses to the challenges and opportunities emanating from the governmentalhealth policy aspects of an organization's external environment; and 3. participate in shaping, to the organization's benefit, the governmental health policy aspects of its external environment. Curriculum design options for providing this content are discussed.

Accreditation↗
PubMed1992

Sudden death during exercise. A cruel turn of events.

The causes of sudden death in exercisers age 35 and younger are generally not preventable because they are typically structural and difficult to detect. The best a physician can do is be alert to important information in the family and patient history and to the occasional sign or symptom that may warrant further evaluation. For the over-35 exerciser, screening tests may be appropriate, especially if the person is just beginning an exercise program, although this remains an area of controversy. The screening tests available are far from perfect. If exercise testing is performed, the asymptomatic patient must be apprised of the possibility of a false-positive result and the consequences and attendant risks of overdiagnosis or additional testing (coronary angiography). Physicians should be alert to suspicious symptoms in physically active patients, but they should avoid the tendency to have these patients stop their exercise program. Instead, after appropriate diagnostic testing, they should advise a modified exercise program that is safely within the limits of the disease process involved. It is important to realize that physical activity can be a preventer of cardiac disease but also a provoker of sudden death. Even so, the benefits of regular exercise clearly outweigh the risk.

Adult↗
PubMed2000

Federalism, entitlements, and discretionary grants: the fiscal context of national support for immunization programs.

This paper defines the appropriation and resource allocation structure of federal government programs that deliver vaccines to the public through state and local governments, with a special focus on the Centers for Disease Control and Prevention (CDC) Section 317 program. The paper places these programs in the context of the overall intergovernmental finance system of the United States, and the manner in which that system has responded to societal changes in other areas, such as unemployment insurance and environmental protection. The paper concludes that a changing environment for vaccine financing, and uncertain appropriations for state government immunization infrastructure, may have made the current CDC Section 317 program inadequate. Increased entitlement resources for federally funded vaccines have not been matched with increased and stable resources for the balance of program costs. To the contrary, funding provided to the Section 317 program has proven unstable, and its discretionary appropriations have proven vulnerable to both executive and legislative branch earmarking for such activities as overseas disease eradication or home state earmarking by congressional appropriations subcommittee members. In addition, the rigidity of some CDC program requirements makes it difficult for states to effectively use program funds. Consideration should be given to strengthening the Section 317 program and its relationships to other federal aid programs to ensure that adequate immunization protections are provided in all states to adequately protect all citizens.

Centers for Disease Control and Prevention, U.S.↗
PubMed2003

Preparing today's teachers of the deaf and hard of hearing to work with tomorrow's students: a statewide needs assessment.

The Individuals with Disabilities Education Act is explicit in its mandate that students who receive special education services have opportunities to be involved in and progress in the general education curriculum. Teachers providing instruction to students who are deaf or hard of hearing are expected to comply with this federal mandate. To determine if teachers of students who are deaf or hard of hearing throughout the state of Georgia felt adequately prepared to educate this population, a statewide needs assessment survey was conducted. Questionnaires were reviewed from 110 experienced teachers of students who are deaf or hard of hearing. More that half of the teachers who responded judged their teacher preparation program to be appropriate. Specific suggestions for modifications to teacher preparation programs are provided.

Adult↗
PubMedDate not supplied

Essential requirements for clinical laboratory science.

OBJECTIVE: To present a sample list of essential requirements for clinical laboratory science (CLS) education that support the requirements of the Americans with Disabilities Act (ADA). The essential requirements provide a basis for student admission and academic progress measurement. DATA SOURCES: Over 700 articles have appeared in various professional and trade journals on the impact of the ADA since it was signed in 1990. DATA EXTRACTION: Literature review. DATA SYNTHESIS: The ADA prohibits discrimination against academically qualified program applicants with disabilities, and requires a list of essential requirements, distinct from academic requirements and distinct from essential functions of jobs, for each academic program. Essential requirements, also called technical standards or functional expectations, are task and attribute-based criteria that define their educational program. Applicants and students must possess or be able to achieve the essential requirements directly or through reasonable accommodations. CONCLUSION: By July 1994, all educators must have been prepared with defensible essential and academic requirements that reflect the needs of their programs, and with appropriate processes for managing applications, academic progress, and program completion that promote equal educational opportunity for qualified individuals with disabilities.

Curriculum↗